Cooper Center for Population Health, Positioning for the Future of Health Care

Staff of Cooper University Health Care in May 2011 marked a turning point for the growing institution. With 30 years of government, education, private sector and entrepreneurial experience, Louis S. Bezich, Chief of Staff of Cooper University Health Care, is charged with bring- ing a fresh, but seasoned, eye to an industry under fire for crippling the economy with its lack of accountability and run- away costs.

The creation of the Cooper Center for Population Health is among Bezich’s first initiatives. The purpose is to explore the best practices to reduce health care costs without cutting or rationing service.

“The rising cost of health care is un- sustainable, so providers around the country are doing this one way or another. Our goal is to get Cooper out front. To enhance our reputation for efficient, collaborative patient-centered care,” says Bezich, who is also Executive Director of the Center for Population Health.

Population Health is a synonym for the kind of “high touch,” patient-centered system that has long been known as ac- countable care. It is not the same as public health, which is a government-driven system that strives to keep safeguards in place to keep society healthy.

While public health may fund the creation of a life-saving vaccine, “Population Health makes sure people actually get the shots,” says Anthony J. Mazzarelli, MD, Cooper’s Senior Vice President and Chief Medical Officer.

Organizationally, the Center is an umbrella that oversees and test drives all innovation with regard to accountable care within the Cooper system. It is a think tank where some of the best ideas in the country are vetted for their applicability to South Jersey. Stephanie M. Watkins, DO, recently joined the team as Physician Advisor to educate Cooper’s doctors and staff about the need for a seismic shift in the delivery of health care and to solicit their support and recommendations. Dr. Watkins serves as a coach and team builder.

Rather than a place or a classroom, Dr. Mazzarelli calls the Center for Population Health a “strategy.”

“Since the beginning of time, we’ve been in the sick business. When you’re sick you come to the hospital. We operate on volume. Therefore, hospitals have zero incentive to keep people healthy. Economics and the federal Accountable Care Act tell us this funding formula has to change. The center will help lead the way,” states Mazzarelli.

Why would a hospital that thrives on volume seek to reduce it? First, under health care reform, the federal government is offering financial incentives to hospitals that reduce volumes and penalties to those that don’t.

Similar carrots and sticks are also in place in the contractual relationships be- tween hospitals and insurance companies. Secondly, hospitals must strive to maximize their competitiveness against a future in which people need them less.

“Population Health is an indictment of the old system or our ongoing system of care,” notes Mazzarelli, adding that “while we are able to provide extraordinary medical care such as saving lives in traumatic incidents, the real challenge is making sure patients take the necessary steps to stay out of the hospital, that they take their medications and keep their primary care appointments.”

Cooper has an extraordinary opportunity to influence change by educating students at the Cooper Medical School of Rowan University. Appropriate training is already in place. The challenge, however, is reinventing a system for established doctors and other providers.

One of the key components of Population Health is anchoring patients to a medical home generally located in a primary care physician’s office. Another is to focus on the highest users of health care, those with chronic or multiple conditions — also known as hot spots or frequent flyers — who need regular monitoring, from nutrition counseling to home visits, and to keep them out of the hospital. Under the direction of John F. Robertson, Jr., MD, Cooper is piloting a program, the Cooper Employee Centered Medical Home, with a slice of its 9,100 covered employees and their families to manage their care.

And, by taking 20 percent equity in AmeriHealth New Jersey — the first venture of its k ind in New Jersey — Cooper is collaborating with an entity that stresses wellness, instead of sickness.

“Insurance companies win when people stay healthy. As a hospital, we can learn from them,” says Mazzarelli.